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I have been billing the 27829 for the syndesmosis repair as well as the orif of whichever bone is fractured as long as the syndesmosis screws are not inserted through the plate used for the orif. You report code 27829 (open treatment of distal tibiofibular joint [syndesmosis] disruption, includes internal fixation, when performed) separately for the syndesmosis repair if a separate incision is made. Chris coetzee, md, (minneapolis, mn) demonstrates an open reduction internal fixation (orif) of an ankle fracture using the distal fibular locking plate with the syndesmosis tightrope ® fixation system.

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It would be appropriate to report cpt code 27792, open treatment of distal fibular fracture (lateral malleolus), includes internal fixation, when performed, for the lateral malleolus fracture that includes the syndesmosis repair if a screw is put through the plate and into the tibia. After the patient was anesthetized, her left lower extremity was prepped and draped in usual sterile fashion. Ankle/syndesmosis orif physical therapy philosophy this protocol is to be utilized as a guideline

There will always be individual differences amongst patients regarding progression and tolerance of specific activities.

Associated fractures should be fixed with orif followed by fluoroscopic external rotation stress testing and evaluation of the medial clear space on mortise views Any detected instability in the syndesmosis should undergo syndesmosis reduction and fixation. How do you find the right lateral malleolus fracture code Open reduction and internal fixation and syndesmotic screw to the left ankle